Getting Diagnosed with Dementia: What Does My Loved One Need?

Dementia is a degenerative condition where an individual’s cognitive abilities (e.g. memory, thinking, processing, language abilities, problem-solving and so on) and functioning decline at a faster rate than what is considered to be normal. It affects 1 in 10 Singaporeans aged above 60 and half of those above 85, and is considered a common condition among seniors. 

Understanding a dementia diagnosis

There are different types of dementia, the most common and most well-known one being Alzheimer’s Disease.

Symptoms of dementia include, but are not limited to:

• Memory loss
• Depression
• Confusion 
• Sudden withdrawal from social activities and engagements 
• Personality and mood changes 
• Difficulty carrying familiar tasks 
• Poor judgment and perception
• Problems with language and communication 

Different types of dementia will present itself in varying ways. As it is a condition which affects the brain, individuals with dementia experience decreasing ability to function independently in everyday life. 

Dementia is usually diagnosed by a doctor who specialises in the condition. The doctor will run some assessments and tests on the individual, and may order brain scans known as CT scans or MRIs. These all help to determine whether someone has dementia.

You can find out more about dementia care through Homage’s e-book, which you can download for free.  

Dealing with the diagnosis 

When someone is diagnosed with dementia, there is a whole barrage of emotions to take in. From relief because you finally have clarity on what is affecting your loved one, to a sense of fear of what is to come as the condition progresses—all of these feelings are difficult to cope with and deal with. Family members of persons with dementia also have to consider what this condition would mean for them as well.

Here’s what your experience of dealing with a loved one’s dementia diagnosis might look like, though it is important to know that not everyone goes through this process in the same order.

1. Accepting the diagnosis 

Acceptance is not an immediate affair. Rather, grief is usually the first immediate response of individuals and their loved ones after such a diagnosis. After all, the diagnosis marks the end of a life once known, and the start of changes in time to come. It is perfectly alright to take time to come to accept the diagnosis.

It is not helpful to rush toward acceptance, or pressure someone into it. 

What is most important is that your loved one with dementia feels and knows he or she is supported as they, too, navigate their new reality. Family members can help to provide reassurance and support by being patient, flexible and open in communication with the individual. This all speaks to the person with dementia that they are not alone in facing this. 

2. Dealing with conflicting emotions

There are various emotional responses upon hearing the diagnosis of dementia, both for the family members of the person with dementia as well as themselves. There is no one way, or one right way, to respond to the diagnosis.

Dealing with conflicting emotions means that some individuals may not be ready to speak about it and may want to live life normally, insisting on carrying through with their usual routines themselves. 

Give them some time to process, and eventually, gently broach the topic with them when they are ready. Listen and reply thoughtfully in a non-judgemental manner, jot down questions you may not have the answer to, and note down their fears, insecurities or thoughts regarding the diagnosis.

You can help them to cope better with their emotions by planning ahead to find answers to questions, reflecting on their fears, and finding some feasible solutions or ways to manage them. As your loved one’s pillar of support, it is essential that you are there to listen to and process these feelings with them. Even if it may be difficult to deal with these emotions, we, as their nearest and dearest, are most helpful when we can be a source of reassurance and comfort. 

As a loved one and caregiver of a person with dementia, you may feel conflicting emotions yourself as well – the frustration of having to take care of someone who was once able, and yet sadness while watching a loved one slip away into the condition can be mentally trying. Having an outlet you can rely on, such as journaling, taking out personal time for self-care, or even hiring caregiving services to take a break, is essential for your own well-being.

Financial subsidies and resources in Singapore for persons with dementia 

Though the journey after diagnosis is long and difficult, there are many resources available to help persons with dementia and their families. From direct caregiving services to financial help or information portals, individuals and family members or carers can tap into these resources to help with care routines, get insight into the condition, and find support.

1. Technology

Assistive devices such as sensor lights or alarms, or GPS trackers, are some tools which can help an individual with dementia increase their own independence in activities of daily living. Moreover, these could help to ease some of the stress of caregivers and family members, who are likely to be fraught with worry when the person with dementia is not in sight and as the condition deteriorates. 

2. Financial aid

The Government has provided several funds and grants to aid with alleviating the financial costs of dementia. Some of these are: 

MediShield Life

MediShield Life is a basic health insurance plan which helps to pay for large hospital bills and selected outpatient treatments, such as dialysis and chemotherapy for cancer. It provides lifelong coverage for all Singaporeans, regardless of their age or pre-existing/existing health conditions.

Community Health Assist Scheme (CHAS)

Clinics under the CHAS scheme can provide subsidised treatment to eligible patients. 

Means Testing for Healthcare Services

Financial assistance can be provided for patients who require healthcare services. This is determined through a Means Testing framework. 

Caregiver Training Grant (CTG)

A $200 fund is available to caregivers or helpers of persons with dementia who wish to take approved courses for caregiving. There are courses available for caregivers on dementia care. 

3. Home assistance 

Extra help around the home can be helpful for persons with dementia and their family members, at different stages of the condition. You may choose to hire a domestic helper or engage in professional caregiving services for your loved one. 

Domestic helper

A helper is probably one of the first options in most people’s minds when they think of extra help. When doing so,  do consider the costs of hiring a helper in Singapore, as well as the level of expertise the domestic helper has when it comes to handling persons with dementia. Hiring a domestic helper can sometimes be a lengthy process. In some cases, where on-demand care is needed, you may consider professional caregiving services as well. 

Caregiving services

If a live-in helper is something the family nor the person with dementia is comfortable pursuing, professional caregivers can be a great alternative. Unlike helpers, caregivers work for a stipulated amount of time and do not need to stay with the family unless requested. Sometimes, the cost of a caregiver can be more affordable than hiring a live-in helper, depending on the situation.

Also, there is more flexibility in hiring a caregiver as you can choose from a short-term versus a longer-term engagement with them. 

Different caregivers are trained differently, so picking one with dementia care experience or training would be ideal. At Homage, all caregivers have undergone professional training, with some specialising specifically in dementia care. Moreover, they can provide companionship and engagement, beyond just support of activities of daily living (ADLs). 

There are different types of care options available, ranging from by the hour per day (Pay As You Go) to a caregiving package calculated by the number of hours of care per month (Prepaid Package). Here are the differences in brief: 

Depending on your needs, if you do know you need longer-term support for your loved one and want to avoid the hassle of having to schedule on a daily basis, you can consider the Prepaid Package for a one-time payment.

How to plan out care for a loved one with dementia

You might be wondering what a day of care for your loved one might look like. 

Let’s take a look at Stacy*, a regular 9-to-5 office worker who is living with and caring for her mother who has dementia.

Stacy’s mother, Mdm Phua*, is in the moderate stages of dementia, which means she requires increased support and help in her daily routine tasks and in communicating with others.

Compared to before, Mdm Phua has frequent mood swings and tries very hard to remember happier times in her past as a store owner in a coffee shop, but gets frustrated as she finds she is starting not to be able to remember much of it in vivid detail. 

Stacy works three full days at the office, and two full days from home, a flexible arrangement agreed upon by her supervisor at work, who knows of her family situation. She usually cares for her mother at night. In the day, her brother, Harry* who works freelance comes over to care for Mdm Phua, but oftentimes is working and sometimes has to leave the house to meet clients.

Likewise, when Stacy is at home, she has to take work calls and reply to urgent requests and deadlines. Mdm Phua often has outbursts directed at her children, blaming them for not giving her undivided attention. This has taken its toll on both siblings, who often bicker due to the increased care needs of Mdm Phua and also the tension from the emotional changes within the family. 

Stacy and Harry have discussed and opted for the Prepaid Package of 40 hours at Homage, to support their mother and also their caregiving efforts. They have decided that they will need five hours of dedicated home care for Mdm Phua per day, while they can continue to care for her in the remaining hours. This can last the family for about eight sessions. The caregiver has recommended a balance of personal care and emotional care for Mdm Phua as shown in the image above. 

With home care, Stacy and Harry can breathe a sigh of relief and focus on their work for a few hours. Mdm Phua also benefits from the focused attention from the caregiver and does not feel so lonely during the day. Her outbursts have lessened as well. 

When someone we care for is diagnosed with dementia, what they likely need is our support and to know that we are walking this journey with them. Consider their needs, and your needs, and tap on the available resources – after all, helping yourself is one of the crucial steps in supporting your loved one as well. 

*Fictional characters for the purposes of illustration

Caring for your loved one with dementia

While there is no cure for dementia, there is a robust support network available for persons with dementia here in Singapore.

As your loved one’s caregiver, do remember that you can get the appropriate help and support you need to give your loved ones the best care they deserve. You are not alone in this journey.